Saturday, June 1, 2013

A Calorie is a Calorie, Right?

Barb Goshorn RN MSACN

“The Nurse Nutritionist”

How long have we been
hearing this? Since the 1960’s, this is the foundation of our belief in what
causes obesity. If we take in more calories than we expend, we get fat. There
are many researchers who are no longer buying into this theory, though. One is
Dr. David Ludwig, of Boston Children’s Hospital and his collaborators. The
Journal of the American Medical Association recently published the results of
his research and instead of excess calories being implicated in the obesity
epidemic, the hormone insulin appears to be the culprit.

Until the 1960’s,
carbohydrates were indeed considered a likely suspect in obesity. “Every woman
knows that carbohydrate is fattening” as two British Dieticians began a 1963
British Journal of Nutrition article. Carbohydrates stimulate the secretion of the
hormone insulin, which works, among other things, to store fats in our fat
cells. In 1921, insulin was discovered and nicknamed, “The fat storage
hormone”. For a number of reasons though, conventional wisdom shifted and
obesity became an energy imbalance issue. Carbohydrates, with less than half
the calories per gram of fat, became the heart-healthy diet food. With this
transformation, fat was removed from foods and we were told to eat low-fat,
carbohydrate-rich foods that would keep us thin.

Unfortunately, this theory
hasn’t seemed to work. Each decade the obesity epidemic grows exponentially. It
may be time to look at an alternate theory as to why we get fat. Dr. Ludwig and
his team concluded that it was the nutrient composition of the diet that
triggered weight gain independent of calories consumed. The fewer carbohydrates
eaten (simple versus complex), the less weight gained and the more carbohydrates
eaten, the more weight the subjects gained. It was concluded, that the
carbohydrates were fattening, and obesity triggered by elevations in insulin,
triggered fat storage.

This is the polar opposite
of what we have been told to eat for decades: eat a low-fat, carbohydrate-rich
diet. The results and conclusion are naturally very controversial. Yet what we
have been educating people to eat obviously hasn’t been working. I know from a
clinical perspective, my clients are most successful when their carbohydrate
intake is from vegetables and fruit with a minimum of grains. Instead of
counting calories, think about eating to avoid huge spikes in insulin.